Rehabilitation leg press apparatus and method

ABSTRACT

An apparatus for rehabilitation of a patient sitting in a wheelchair, the apparatus having a passive support, an active support, a vertical motion restricting device, a wheelchair securing device, a horizontal motion device with respect to the passive support, and a horizontal motion device with respect to the vertical motion restricting device. Also, a method for rehabilitation of a patient when the patient is sitting in a wheelchair, the method having the steps of passively supporting the wheelchair, actively supporting the wheelchair, vertically restricting motion of the wheelchair, securing the wheelchair, and horizontally moving the wheelchair.

TECHNICAL FIELD AND BACKGROUND

The present invention relates, in general, to an apparatus for strengthening and rehabilitating the lower portion of the human body. More specifically, the present invention relates to a rehabilitation leg press apparatus, useable with a wheelchair, such that people that use and need wheelchairs can exercise and rehabilitate their lower bodies while remaining seated in a wheelchair with minimum risk.

The prior art discloses various apparatuses in which the wheelchair functions as a support seat for the exercise apparatus. The wheelchair is often static or stationary. In many cases, the wheelchair is fastened to pedal assemblies for a bicycle-type of exercise. Many prior exercise apparatuses make accommodations for a wheelchair in upper body exercise equipment, or include a wheelchair treadmill-type exercise apparatus, in which the wheelchair rolls on rollers when the operator pushes the large wheels of the wheelchair for upper body exercise. Some prior exercise apparatuses are provided for passive exercises for the lower body and dynamic upper body exercises, apparently since most wheelchair users have lower body handicaps or are paralyzed. None of the prior art devices includes the wheelchair as a moving part of the exercise apparatus.

Although many devices have been proposed for accommodating a patient in a wheelchair, none of these prior devices are particularly suited for use with bariatric rehabilitation patients who are regaining the ability to stand and walk, where the patient can stay in the wheelchair while exercising their legs, where the wheelchair is stabilized during exercise and prevented from tipping, especially tipping backward, where the patient can exercise in a manner that simulates and develops sit-to-stand motions and ability in patients, and where the patient can exercise so as to strengthen muscles and achieve a cardiovascular workout.

The apparatus and method of the present invention may comprise one or more features, which address one or more (or all) of the above-referenced problems and deficiencies in the prior art. Other objects, features and advantages of the present invention will be apparent from the accompanying drawings, and from the detailed description that follows below.

BRIEF DESCRIPTION OF THE DRAWINGS

The objects, features, and advantages of the present invention will be apparent from the following detailed description of an embodiment of the invention with references to the following drawings.

FIG. 1 is a side view of an embodiment of the present leg press apparatus with a wheelchair positioned in an operative position in the apparatus.

FIG. 2 is a side view of an embodiment of the present leg press apparatus.

FIG. 3 is a front view of an embodiment of the present leg press apparatus with a wheelchair positioned in an operative position in the apparatus.

FIG. 4 is a front view of an embodiment of the present leg press apparatus.

FIG. 5 is a partial top view of a wheelchair positioned in a carriage of the leg press apparatus in an embodiment of the present leg press apparatus.

FIG. 6 is a partial side view of a linear motion assembly of the leg press apparatus in an embodiment of the present leg press apparatus; and

FIG. 7 is a side view of an embodiment of the present leg press apparatus.

DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

The present invention is an exercise apparatus for people who use wheelchairs or are wheelchair bound. The present invention is particularly suited for use with bariatric rehabilitation patients who are regaining the ability to walk. The patient can stay in the wheelchair while exercising their legs. The apparatus stabilizes the wheelchair during exercise and prevents the wheelchair from tipping, especially tipping backward. Also, the apparatus allows the therapist to monitor patient activity without manually assisting in the activity (line-of-sight supervision). The apparatus permits exercise that simulates and develops sit-to-stand motions, activity tolerance and sit-to-stand ability in patients. This type of exercise both strengthens muscles and provides a cardio-vascular workout.

In the present invention, a wheelchair exerciser assembly is provided which supports a person in a wheelchair while performing dynamic compound lower body exercises, especially leg press type or simulated sit-to-stand exercises. To achieve this function, the present invention includes structure to stabilize a wheelchair and to restrict the movement of the wheelchair to one direction or plane. Thus, the present invention includes a one-directional or single-plane slide-platform assembly to which the front wheels of a wheelchair are fixedly engaged. Although the terms “horizontal” and “vertical” may be used to describe the present apparatus, it is understood that the apparatus may be provided in any suitable configuration which performs the functions described herein. For example, the terms horizontal and vertical may describe the planes in which portions of the apparatus are disposed, but are not intended to limit the configuration of the apparatus to strictly horizontal and vertical configurations. The entire device may be provided at an angle so that the direction of back-and-forth motion is along an inclined plane.

Further, the present invention includes a pushing-platform that the patient pushes with his feet and resistive apparatus that provide resistive force against which the patient must push. The wheelchair exerciser is designed to accommodate a large variety of wheelchair sizes. The present invention is designed to be especially used in a physical therapy or physical rehabilitation setting.

FIG. 1 is a side view of an embodiment of the present leg press apparatus 10 with a wheelchair 12 positioned in an operative position in the apparatus 10. The apparatus 10 has a base structure (or support chassis or support structure) 16. The base structure 16 may be made of one-piece construction or multiple components as shown. The base structure 16 may be made of any suitable material, such as wood, plastic or metal or a combination of wood, plastic and/or metal. If the base structure 16 is provided with multiple components as shown, the components may be connected using any suitable means of connection, such as screws.

The base structure may comprise a lower plate 16 a, a pair of lower beams 16 b on the lower plate 16 a, a pair of middle plates 16 c on the lower beams 16 b, a pair of upper beams 16 d, and a pair of upper plates or restrictor plates 16 e on the pair of upper beams 16 d. As detailed in FIG. 4, the lower plate 16 a may be connected with a cross beam 17, which is provided between the pair of lower beams 16 b.

The base structure 16 may be provided with a vertical support member 18 and may be stabilized with the aforementioned cross beam 17 and a corner support member 19. The support members 18 and 19 may be constructed in a manner similar to that of the base structure 16 described above. For example, the vertical support member 18 may be formed of plywood and attached to base structure 16 with screws and with a corner support member 19 formed of metal, plastic, PVC or the like. The corner support member 19 may also be attached with any suitable means for connection, such as screws. In the illustrated embodiment, the corner support member 19 is triangular in shape and comprises a horizontal piece, a vertical piece and an angled cross piece between the horizontal and vertical pieces, where the horizontal piece is attached to the base structure 16 and the vertical piece is attached to the vertical support member 18, and where the angled cross piece is integrated into a one-piece construction with the horizontal and vertical pieces.

Referring, for example, to FIG. 2, a press board 14 may be attached between the vertical support member 18 and the base structure 16. Specifically, the press board 14 may be provided at an angle A with respect to the vertical and attached at a top of the vertical support member 18 and to a top side of the lower plate 16 a. In operation, a patient places his or her feet against the press board 14. It has been found than the angle A should be less than about 45 degrees with respect to the vertical, preferably between about 15 degrees and about 30 degrees, and even more preferably between about 20 degrees and about 25 degrees. It has been found that by positioning of the press board 14 at the angle A within the ranges specified above, an optimal position is provided for the patient during exercise. The press board 14 may be provided such than angle A may be adjustable for individual preference.

The press board 14 may further comprise a foot support 20. The foot support 20 may also be adjustable in any direction on the press board 14 and may be adapted to receive the feet of the patient during exercise or individualized to meet the needs of a particular patient.

A means for resistance 26 may be attached at any suitable position on the apparatus 10. For example, in an example of a relatively simple type of construction, the means for resistance 26 may be attached to the press board 14 using stays, eyelets or loops 15. The stays, eyelets or loops 15 could be screwed into the press board 14 or attached using any suitable means. The stays, eyelets or loops 15 may be made of suitable material such as metal, wood, plastic or the like.

The means for resistance 26 may be made of any suitable material. For example, the means for resistance 26 may be one or more means of dynamic resistance, such as elastic bands or bungee cords. In the illustrated embodiment, three pair of bungee cords are used, one pair on each side. Multiple resistances could be achieved by providing elastic bands or bungee cords with different levels of elastic resistance and/or by providing multiple bands or cords which together achieve the desired resistance. In any event, the means for resistance 26 is provided between the wheelchair 10 and the press board 14. In operation, the wheelchair 10 is provided in a carriage 32 (to be described in greater detail below), and as the patient presses on the press board 14, the means for resistance 26 provides resistance to the legs of the patient as the carriage 32 moves with the wheelchair 10.

FIG. 2 is a side view of an embodiment of the present leg press apparatus 10 without the wheelchair 12. In addition to the features described above, FIG. 2 also shows wheel receptacles 34 provided in the carriage 32. Although an opening is shown in the illustrated embodiment, any suitable means for securing the wheelchair 10 may be provided. For example, the wheel receptacles 34 may be an opening in the carriage 32 (as shown), or the wheel receptacles 34 could be a wheel cup (not shown) provided in a shape specifically adapted to receive front wheels 13 of the wheelchair 10. The wheel cup could be made of any suitable material such as metal, plastic or wood.

Also, the carriage 32 comprises a pair of upper wheels 36 attached to the carriage 32 with mounting brackets 35. It is noted that one of the pair of upper wheels 36 is shown in FIG. 2. Both of the pair of upper wheels 36 are shown, for example, in FIGS. 3, 4 and 6. Although upper wheels 36 are shown, any suitable means of providing for the horizontal movement of the carriage 32 may be employed.

Also, FIG. 2 shows a pair of tracks 30 adapted to receive and secure a pair of lower wheels 38 (as detailed in FIGS. 3 and 4). Although a pair of tracks 30 are shown, any suitable means of receiving and securing the lower wheels 38 may be used. The tracks 30 may be made of any suitable material such as metal, wood or plastic.

FIG. 3 is a front view of an embodiment of the present leg press apparatus 10 with a wheelchair 12 positioned in an operative position in the apparatus 10. In addition to the features shown in FIGS. 1 and 2, FIG. 3 also shows that the carriage 32 comprises a pair of lower wheels 38 attached to the carriage 32 with mounting brackets 37.

FIG. 4 is a front view of an embodiment of the present leg press apparatus 10 without the wheelchair 10 including all the features shown in FIGS. 1-3.

FIG. 5 is a partial top view of a wheelchair 12 positioned in a carriage 32 of the leg press apparatus 10 in an embodiment of the present leg press apparatus 10. As noted above, the means for resistance 26 may be attached at any suitable position on the apparatus 10 and elastic bands or bungee cords may be used as the means for resistance 26. As detailed in FIG. 5, for example, a first end of a first band or cord may be attached to a first loop, the first band or cord may be wrapped around a first side of the frame of the wheelchair 10, and a second end of the first band or cord may be attached to the same first loop. Then, a first end of a second band or cord may be attached to a second loop, the second band or cord may be wrapped around a second side of the frame of the wheelchair 10, and a second end of the second band or cord may be attached to the same second loop. Also, a means for static resistance, such as a fastening strap, stay tether, steel rod or bar 40 made of woven nylon, rope, metal or any other suitable material, can be attached between the wheelchair 10 and the carriage 32. Although any suitable means for static resistance may be used, as shown in FIG. 5, a first end of the strap or tether 40 can be attached to a first stay, eyelet or loop 33 on one side of the carriage 32, the strap or tether 40 can be looped through the frame of the wheelchair 10 and a second end of the strap or tether 40 can be attached to a second stay, eyelet or loop 33 on another side of the carriage 32. Optionally, a rigid retaining bar may be used instead of the strap or tether 40.

FIG. 6 is a partial side view of the carriage 32 of the leg press apparatus 10 in an embodiment of the present leg press apparatus 10. FIG. 6 details the pair of upper wheels 36 adapted to roll against a bottom side of the pair of upper plates or restrictor plates 16 e. Since the pair of upper wheels 36 are adapted to roll against the bottom side of the pair of upper plates or restrictor plates 16 e, the carriage 32 is restricted from vertical movement within the apparatus 10. As noted above, the entire apparatus 10 may be disposed at an angle, and it is understood that the restrictor plates 16 e would still function to prevent improper or undesired disengagement of the wheelchair 12 from the apparatus 10. Since the wheelchair 10 is attached to the carriage 32 with a means for static resistance, such as fastening strap, stay tether, steel rod or bar 40 (see, for example, FIG. 5), the wheelchair 10, in operation, is restricted by the pair of upper plates or restrictor plates 16 e and is thus prevented from tipping over or rising off the surface formed by lower plate 16 a during operation. This provides stability to the patient and permits the patient to engage in a full range of motion and increased force during exercise thus improving the exercise for the patient.

FIG. 7 is a side view of the entire apparatus 10 may be provided at an angle so that the lower plate 16 a is disposed at an incline and so that the wheelchair 12 rolls back and forth in a direction that is not horizontal. For example, the apparatus 10 may be disposed at any angle between 0 and 45 degrees. As the angle increases, the patient would need to increase the force required to complete a repetition. As such, the leg press apparatus may be adapted to incorporate the force of gravity into the exercise. Shown is a control button 50 to drop the apparatus 10 to a level position.

In one embodiment of the present invention, an apparatus for rehabilitation of a patient, such as a bariatric patient, sitting in a wheelchair 12, is provided. The apparatus may comprise a means, such as support structure 16, for passive support; a means, such as carriage or slide platform 32, for active support; a means, such as restrictor plate 16 e, for restricting vertical motion of the means for active support; a means, such as wheel receptacles 34, for securing the wheelchair 12; a means, such as lower wheels 38, for horizontal motion with respect to the means for passive support; a means, such as upper wheels 36, for horizontal motion with respect to the means for restricting vertical motion of the means for active support; a means, such as elastic bands 26, for elastic resistance; and a means, such as fastening strap, stay tether, steel rod or bar 40, for static resistance.

The apparatus may be provided such that the means, such as support structure 16, for passive support comprises the means, such as restrictor plate 16 e, for restricting vertical motion of the means for active support.

The apparatus may be provided such that the means, such as carriage or slide platform 32, for active support comprises the means, such as wheel receptacles 34, for securing the wheelchair 12.

The apparatus may be provided such that the means, such as carriage or slide platform 32, for active support comprises the means, such as lower wheels 38, for horizontal motion with respect to the means for passive support.

The apparatus may be provided such that the means, such as carriage or slide platform 32, for active support comprises the means, such as upper wheels 36, for horizontal motion with respect to the means for restricting vertical motion of the means for active support.

The apparatus may be provided such that the means, such as elastic bands 26, for elastic resistance is provided between the means, such as support structure 16, for passive support and the means, such as carriage or slide platform 32, for active support.

The apparatus may be provided such that the means, such as fastening strap, stay tether, steel rod or bar 40, for static resistance is provided between the wheelchair 12 and the means, such as carriage or slide platform 32, for active support.

In one embodiment of the present invention, an apparatus 10 for rehabilitation of a patient sitting in a wheelchair 12 is provided. The apparatus 10 may comprise a support structure 16; a carriage or slide platform 32; a carriage or slide platform 32 vertical motion restrictor device 16 e; a receiver or wheel receptacles 34 for the wheelchair 12; a first rolling device 38, such as a first wheel, for horizontal motion with respect to the support structure 16; a second rolling device 36, such as a second wheel, for horizontal motion with respect to the carriage or slide platform 32 vertical motion restrictor device 16 e; an elastic resistance device 26; and a static resistance device 40.

The apparatus 10 may be provided such that the support structure 16 comprises the carriage or slide platform 32 vertical motion restrictor device 16 e.

The apparatus 10 may be provided such that the carriage or slide platform 32 comprises the receiver or wheel receptacles 34 for the wheelchair 12.

The apparatus 10 may be provided such that the carriage or slide platform 32 comprises the first rolling device 38 for horizontal motion with respect to the support structure 16.

The apparatus 10 may be provided such that the carriage or slide platform 32 comprises the second rolling device 36 for horizontal motion with respect to the carriage or slide platform 32 vertical motion restrictor device 16 e.

The apparatus 10 may be provided such that the elastic resistance device 26 is provided between the support structure 16 and the carriage or slide platform 32.

The apparatus 10 may be provided such that the static resistance device 40 is provided between the wheelchair 12 and the carriage or slide platform 32.

The present invention is also directed to a method for rehabilitation of a patient when the patient is sitting in a wheelchair 12, the method comprising the steps of passively supporting the wheelchair 12, for example, with support structure 16; actively supporting the wheelchair 12, for example, with carriage 32; vertically restricting motion of the wheelchair 12, for example, with restrictor plate 16 e; securing the wheelchair 12, for example with wheel receptacles 34; horizontally moving the wheelchair 12, for example, using the carriage 32 with upper wheels 36 and lower wheels 38; providing elastic resistance to the wheelchair 12, for example, with elastic bands 26; and providing static resistance to the wheelchair 12, for example, with fastening strap, stay tether, steel rod or bar 40, where resistance may be applied to the carriage via eyelets.

The method may be provided such that the step of passively supporting the wheelchair 12 comprises the step of vertically restricting motion of the wheelchair 12.

The method may be provided such that step of actively supporting the wheelchair 12 comprises the step of securing the wheelchair 12.

The method may be provided such that the step of actively supporting the wheelchair 12 means comprises the step of horizontally moving the wheelchair 12.

The method may further comprise a step of attaching a means, such as elastic bands 26, for elastic resistance between a passive support means and a means, such as carriage or slide platform 32, for active support.

The method may further comprise a step of attaching a means, such as fastening strap, stay tether, steel rod or bar 40, for static resistance between the wheelchair 12 and a means, such as carriage or slide platform 32, for active support.

A rehabilitation leg press apparatus 10, the apparatus 10 usable with a wheelchair 12, the apparatus 10 comprising a support chassis 16; a carriage 32 configured for reciprocating motion having at least one wheelchair receptacle 34; at least one linear motion assembly is connected to the carriage; a press board 14; a means for resistive force that is configured to resist the leg pushing motion of a wheelchair 12 user; and a means for securing a wheelchair 12 to the carriage.

The rehabilitation leg press apparatus 10 may be provided such that the at least one linear motion assembly comprises at least one linear motion assembly configured at opposite sides of the carriage 32 and each linear motion assembly comprises an upper and a lower track 30; at least one upper track wheel 36; at least one lower track wheel 38; and a stabilizer piece (not shown).

The rehabilitation leg press apparatus 10 may be provided such that the support chassis 16 further includes a vertical support 18; a base support; and a corner support 19 bracket.

The rehabilitation leg press apparatus 10 may be provided such that the press board 14 is adjustable such that the press board 14 can be configured at different angles to a wheelchair 12 user.

The rehabilitation leg press apparatus 10 may be provided such that the press board 14 further includes at least one foot support 20.

The rehabilitation leg press apparatus 10 may be provided such that the at least one foot support is adjustable and can be configured at different positions on the press board 14.

The rehabilitation leg press apparatus 10 may be provided such that the at least one wheelchair receptacle 34 is configured to receive and support front wheels of the wheelchair 12 such that the front wheels of the wheelchair 12 are positioned out of contact with a running surface on which the wheelchair 12 moves.

The rehabilitation leg press apparatus 10 may be provided such that the at least one wheelchair receptacle 34 can receive and support front wheels of various sizes of different wheelchairs 12.

The rehabilitation leg press apparatus 10 may be provided such that the at least one wheelchair receptacle 34 further includes a bottom cup portion that is configured in an arc-like shape, such that front wheels of the wheelchair 12 can be received and supported by the bottom cup portion.

The rehabilitation leg press apparatus 10 may be provided such that the means for resistive force is at least one tension band or static stay.

The rehabilitation leg press apparatus 10 may be provided such that the means for resistive force includes a weight lifting apparatus such that the operator lifts the weights while pushing against the press board 14.

The rehabilitation leg press apparatus 10 may be provided such that the weight lifting apparatus includes at least one weight plate; at least one pulley assembly; and at least one cable. The weight lifting apparatus may also comprise a hydraulic device.

The rehabilitation leg press apparatus 10 may be provided such that the means for securing a wheelchair 12 to the carriage 32 is configured to prevent the wheelchair 12 from tipping over during operation by a wheelchair 12 user.

The rehabilitation leg press apparatus 10 may be provided such that the means for securing a wheelchair 12 to the carriage 32 includes a tether and a plurality of tether stays 33 fastened to the carriage.

The rehabilitation leg press apparatus 10 may be provided such that the means for securing a wheelchair 12 to the carriage 32 includes a bar and a plurality of bar fixtures fastened to the carriage.

In another embodiment of the present invention, a rehabilitation leg press apparatus 10 is provided usable with a wheelchair 12 comprising a wheelchair 12; a support chassis 16 further including a vertical support 18, a base support, and a corner bracket 19; a carriage 32 configured for reciprocating motion having at least one wheelchair receptacle 34; where the at least one wheelchair receptacle 34 is configured to receive and support front wheels 13 of the wheelchair 12 such that the front wheels 13 of the wheelchair 12 are positioned out of contact with a running surface for the wheelchair 12; at least one linear motion assembly configured at opposite sides of the carriage, each linear motion assembly further including an upper track (not shown), a lower track 30, at least one upper track wheel 36, at least one lower track wheel 38, and a stabilizer piece (not shown); an adjustable press board 14 further including an adjustable foot support 20 such that the foot support 20 can be configured at different positions on the press board 14; at least one tension band 26 that is configured to resist the leg pushing motion of a wheelchair 12 user; a means for securing the wheelchair 12 to the carriage, such that the wheelchair 12 will not tip over during operation by a wheelchair 12 user; and the means for securing the wheelchair 12 to the carriage 32 further includes a tether 40 and a plurality of tether stays 33 fastened to the carriage 32.

In yet another embodiment of the present invention, a method of using a rehabilitation leg press apparatus 10 is provided, the method comprising positioning a wheelchair 12 into the leg press apparatus 10; positioning front wheels 13 of the wheelchair 12 in at least one wheelchair receptacle 34 of a carriage 32, such that the front wheels 13 are positioned out of contact with a running surface on which the wheelchair 12 moves; securing the wheelchair 12 to the carriage 32, such that the wheelchair 12 will not tip over during operation by a wheelchair 12 user, by threading a tether 40 through a frame of the wheelchair 12 and fastening opposite sides of the tether 40 to two stays 33 at opposite sides of the carriage 32; connecting the wheelchair 12 to a resistive force assembly configured to resist the leg pushing motion of a wheelchair 12 user; and operating the leg press assembly 10, which further includes alternating a leg press motion and a leg retract motion, where during the leg press motion, a wheelchair 12 user pushes with a forward push force of a lower body of the user against a press board 14 to move the wheelchair 12 rearward, and during the leg retract motion, a wheelchair 12 user allows the resistive force to overcome the rearward push force of the lower body to move the wheelchair 12 rearward.

Although the present invention has been described in terms of specific exemplary embodiments, it will be appreciated that various modifications and alterations might be made by those skilled in the art without departing from the spirit and scope of the invention as set forth in the following claims. 

1. An apparatus for rehabilitation of a patient sitting in a wheelchair, the apparatus comprising: a means for passive support; a means for active support; a means for restricting vertical motion of the means for active support; a means for securing the wheelchair; a means for horizontal motion with respect to the means for passive support; and a means for horizontal motion with respect to the means for restricting vertical motion of the means for active support.
 2. The apparatus of claim 1, wherein the means for passive support comprises the means for restricting vertical motion of the means for active support.
 3. The apparatus of claim 1, wherein the means for active support comprises the means for securing the wheelchair.
 4. The apparatus of claim 1, wherein the means for active support comprises the means for horizontal motion with respect to the means for passive support.
 5. The apparatus of claim 1, wherein the means for active support comprises the means for horizontal motion with respect to the means for restricting vertical motion of the means for active support.
 6. The apparatus of claim 1, wherein the apparatus further comprises a means for dynamic resistance and a means for static resistance; and wherein the means for dynamic resistance is provided between the means for passive support and the means for active support.
 7. The apparatus of claim 1, wherein apparatus further comprises a means for dynamic resistance and a means for static resistance; and wherein the means for static resistance is provided between the wheelchair and the means for active support.
 8. An apparatus for rehabilitation of a patient sitting in a wheelchair, the apparatus comprising: a support structure; a carriage; a carriage vertical motion restrictor device; a receiver for the wheelchair; a first rolling device for horizontal motion with respect to the support structure; and a second rolling device for horizontal motion with respect to the carriage vertical motion restrictor device.
 9. The apparatus of claim 8, wherein the support structure comprises the carriage vertical motion restrictor device.
 10. The apparatus of claim 8, wherein the carriage comprises a selected one of the receiver for the wheelchair and the first rolling device for horizontal motion with respect to the support structure.
 11. The apparatus of claim 8, wherein the entire apparatus is at an angle so that the lower plate is disposed at an incline and so that the wheelchair rolls back and forth in a direction that is not horizontal.
 12. The apparatus of claim 8, wherein the carriage comprises the second rolling device for horizontal motion with respect to the carriage vertical motion restrictor device.
 13. The apparatus of claim 8, wherein the apparatus further comprises a dynamic resistance device and a static resistance device; and wherein the dynamic resistance device is provided between the support structure and the carriage.
 14. The apparatus of claim 8, wherein the apparatus further comprises a dynamic resistance device and a static resistance device; and wherein the static resistance device is provided between the wheelchair and the carriage.
 15. A method for rehabilitation of a patient when the patient is sitting in a wheelchair, the method comprising the steps of: passively supporting the wheelchair; actively supporting the wheelchair; vertically restricting motion of the wheelchair; securing the wheelchair; and horizontally moving the wheelchair.
 16. The method of claim 15, wherein the step of passively supporting the wheelchair comprises the step of a selected one of horizontally and vertically restricting motion of the wheelchair.
 17. The method of claim 15, wherein step of actively supporting the wheelchair comprises the step of securing the wheelchair.
 18. The method of claim 15, wherein the entire apparatus is at an angle so that the lower plate is disposed at an incline and so that the wheelchair rolls back and forth in a direction that is not horizontal.
 19. The method of claim 15, the method further comprising steps of providing dynamic resistance to the wheelchair; providing static resistance to the wheelchair; and attaching a means for dynamic resistance between a passive support means and a means for active support.
 20. The method of claim 15, the method further comprising steps of providing dynamic resistance to the wheelchair; providing static resistance to the wheelchair; and attaching a means for static resistance between the wheelchair and a means for active support. 